| NPI | 1467029587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN SAADY SAXE Administrative Coordinator 813-541-4840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2022-04-27 |